Matrix metalloproteinase-9 plays an important role in the blood-brain barrier disruption.Blood-brain barrier disruption may directly influence the neurovascuiar unit repair after cerebral ischemia.An in-depth study of matrix metalloproteinase-9-mediated ischemic brain damage and neurovascular remodeling is expected to open up a new way for the diagnosis and treatment of cerebral ischemia in clinical practice.

Objective To investigate the eftect of VEGF gene transtection on endothelial progenitor cell derived from murine bone marrow.Methods Wistar rat's bone marrow was obtained, mononuclear cell isolated,and endothelial progenitor cells(EPS)were cultured in EGM-2MV.EPCs were identified by immunocytochemistry and electron microscope.EPCs were transfected by liposome mediated pcDNA3.0-hVEGF165.VEGF protein level was determined in the cultural medium supernatant after VEGF transfection by ELISA.Cultural medium supernatant was used to co-culture with ECV304,VEGF protein activity was evaluated by MTT.EPCs expression of vWF,VEGF,FLK-1 was detected by immunocytochemistry.Results EPCs were effectively enriched by EGM-2MV,and the EPCs obtained express the typical cell surface markers such as CD34,CD133,FLK-1.The concentration of VEGF protein in supernatant reaches 1280 pg/ml in the 7th day after pcDNA3.0-hVEGF transfection.No influence of EPCs proliferation could be found after transfeetion.The cell surface marker expression of VEGF,FLK-1, vWF became higher with time,and the ratios of positive cell were 88.52%,82.65% and 95.97% respectively.Conclusions pcDNA3.0-hVEGF165 transfeet EPCS mediated by liposome could excrete a high concentration of functional VEGF protein.It is helpful for EPC to maintain the characters of endothelial cell after VEGF gene transfection and differentiate to mature endothelial cell.

Objective To explore possible mechanisms of the cross-over observed in stroke patients comple-ting a line bisection test. Methods Twenty-five stroke patients with left neglect and twenty normal subjects were studied.In the ordinary line bisection test,there are two papers presenting 20 mm and 100 mm lines respectively.On each paper,three lines with the same length are presented at the left,middle and right of the paper.In the line im-age test,the two papers are the same as in line bisection test,but here subjects are asked to set endpoints of each re-al line. Results Replicating earlier findings,length cross-over was observed in the patients with neglect.In the hline image test,those patients neglected lines on both sides but with a much larger proportion on the left.The patientsunderestimated long lines as in previous studies,but they also underestimated very short lines in contrast to earlier findings. Conclusion Foveal neglect sparing may explain these observations.For very short lines,the left end of the line falls into foveal vision and the left part of the line was not neglected.As a result,the crossover effect of line length occurs.

Objective To observe the effect of neuromuscular electrical stimulation (NMES) at different intensities on functional swallowing and the velocity of hyolaryngeal excursion in post-stroke dysphagia.Methods Thirty stroke survivors with dysphagia were randomly divided into a control group,an NMES group and an intensive NMES group,each of 10.All 3 groups received conventional swallowing training,while the patients in the NMES group also received NMES at 30 ～ 80 Hz in an intensity of ≤ 25 mA once a day and those in the intensive NMES group received it twice a day.Before,as well as 2 and 4 weeks after the treatment,video fluoroscopy when swallowing pap was used to determine the superior and anterior excursion distances of the hyoid and larynx and the excursion's duration and the corresponding velocity.A water drinking test (WDT) was also administered,and dysphagia severity scale (DSS) and penetration-aspiration scale (PAS) ratings were assessed.Results After the treatment,significant improvement was observed in the average WDT,DSS and PAS scores of all three groups compared to before the treatment.The average WDT score of the intensive NMES group was significantly better than that of the control group after 2 weeks of treatment.After 2 and 4 weeks of treatment,the average DSS of the intensive NMES group was significantly better than that of the control group,while the intensive NMES group's average PAS score was significantly better than those of both of the other groups.The average anterior hyoid excursion velocity of the intensive NMES group was significantly faster than those of the other two groups after both 2 and 4 weeks of treatment.Pearson correlation analysis indicated that the PAS score was significantly correlated with the anterior hyoid excursion velocity.Conclusion Two NMES sessions a day are superior to only one session in improving functional swallowing after stroke.It better promotes quick movement of the body parts involved.

Objective To explore the effect of neuromuscular electrical stimulation(NMES) on hyolaryngeal structural movement in post-stroke dysphagia.Methods Thirty patients with post-stroke dysphagia were randomly divided into 3 groups (n =10) namely group A,group B and group C.On the basis of routine swallowing training,medication and rehabiliation given to group C,group A was provided with VitalStim therapy on both suprahyoid and infrahyoid muscles,while group B was only on suprahyoid muscles lasting 2 weeks.Before and after treatment,the Video Fluoroscopy Swallowing Study (VFSS) was carried out and the upward and forward displacement distances of the hyoid and thyroid cartilage when swallowing pap were measured.Moreover,water swallow test,dysphagia severity scale and DOSS scores were used to assess the swallowing function.Results After 2 weeks' treatment,the water drinking test score,dysphagia severity scale and DOSS scores increased significantly in all groups than before treatment.The water drinking test score of group A (2.40 ± 1.26) and group B (2.10 ± 0.99),dysphagia severity scale of group A (5.30 ± 1.89) and group B(5.20 ± 1.69),as well as the DOSS level of group A (5.20 ± 1.40) and group B (5.10 ± 1.45) were significantly better than the control group.However,no significant difference was observed in all measurements between group A and group B.The group B revealed a significantly increase in anterior hyoid excursion distance of (12.15 ± 7.59) mm,much bigger than that before treatment and that of group A and B after treatment.Conclusion NMES on the basis of traditional swallowing training can improve the swallowing function of post-stroke dysphagia patients,and NMES on suprahyoid muscles can further induce an increase in anterior hyoid excursion.

Objective To compare the early renal function recovery after kidney transplant from donation after cardiac death (DCD) and brain death (DBD).Methods The Medline (1950-2011),Embase and Cochrane library database were searched and supplemented by review of conference proceedings and publication bibliographies.All original single institution studies reporting outcomes for DCD and DBD kidney transplant recipients were considered.Odds ratios (OR) and 95％ confidence intervals (CI) based on random effects models were calculated.Results Nine publications,all cohort studies,involving 2049 DCD and 5498 DBD recipients,were included.DCD recipients had 7.24 times increased odds of DGF (OR=7.24,95％ CI =3.86-13.58),and 4.97 times increased odds of PNF (95％ CI =3.77-6.55).Conclusion DCD renal transplantation is associated with higher risks of DGF and PNF.

Objective To observe the effects of neuromuscular stimulation (NMES) intensity on post-stroke dysphagia.Methods Thirty patients with dysphagia resulting from a stroke were randomly divided into a control group,an NMES group,and an intensive NMES group,with 10 patients in each.The 3 groups all received conven-tional swallowing training.Patients in the NMES group also received NMES once a day and those in the intensive NMES group received it twice a day.Kubota's water drinking test and videofluoroscopy were used to assess the subjects' swallowing function before treatment and after 2 and 4 weeks of treatment.Results After 2 weeks,the average water drinking test score was significantly better in the intensive NMES group than in the control group.The fluoroscopic results of all three groups had improved significantly,but the results in the NMES group and the intensive NMES group were significantly better than those of the control group.The intensive NMES group also scored significantly higher than the NMES group.Conclusion NMES can improve the swallowing reflex and the contraction of the suprahyoid muscles.It can strengthen the effect of re-learning swallowing.Two NMES sessions a day are better than one.

Objective To observe the effects of citalopram and physical therapy on poststroke depression(PSD).Methods72 patients with PSD were randomly divided into medicine group(n=36)and control group(n=36).The patients in the control group were treated only with physical therapy and the patients in the medicine group were treated with Citalopram and physical therapy.All patients were assessed with Zung Self-Rating Depression Scale(ZSDS)and Modified Barthel index(MBI)before and after treatment.ResultsAfter treatment,the Zung score in both groups decreased significantly(P<0.01).Meanwhile,the medicine group showed significantly less depression than the control group(P<0.05).The score of MBI was also significantly increased after treatment(P<0.01)in both group,but there was no significant difference between two groups(P>0.05).ConclusionCitalopram combined with physical therapy is effective on PSD.

ObjectiveTo study the effect of tetramethylpyrazine cooperated with autogenous periosteum graft on fibrous scar formation in the epidural space after laminectomy. Methods48 SD rats were divided randomly into 4 groups. Laminectomy was performed in lumbar 2 segment, and the exposed duras were covered with saline solution (group A), tetramethylpyrazine (group B), autogenous periosteum (group C), and tetramethylpyrazine and autogenous periosteum (group D) respectively. 12 weeks postoperatively, they were evaluated with the gross and histopathological observation, biochemistry examination. ResultsThe assessment of Rydell-Balazs and Nussbaum's Criterion of group B, C, D were obviously better than that of group A (P<0.01), and that of group D was superior to group B and C (P<0.05), no significant difference between group B and C (P>0.05). ConclusionTetramethylpyrazine cooperated with autogenous periosteum graft has a better effect on prevention peridural adhesion after laminectomy.

Objective To investigate the relationship among health literacy and treatment compliance and prognosis in patients with diabetes combined tuberculosis.Methods One hundred and eighty-one cases patients with diabetes combined tuberculosis were selected as the objectives and evaluated literacy level,compliance scale by the health literacy scale and compliance questionnaires.The control of tuberculosis,blood glucose control,treatment compliance and prognosis were analyzed in the patients with different health literacy level.Results Of 181 patients,there were 89 cases patients'(basic health literacy group) the total scores of health literacy and compliance were＞80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 84.2％ (75/89) and 93.2％ (83/89);92 cases patients' the total scores of health literacy and compliance were ≤ 80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 59.7％ (55/92) and 67.4％ (62/92),the differences were significant (x2 =12.78,18.11;P ＜0.05).Pearson correlation analysis showed that the total scores of health literacy were positive correlated with the scores of treatment compliance (r =0.688,P ＜ 0.001).Logistic regression analysis showed that three dimension of health literacy (health knowledge and concept,healthy lifestyle and behavior,health skills) that can combined predict the variance of rehabilitation compliance(P＜0.01).Conclusion The health literacy level of diabetes combined tuberculosis patients can effectively predict the rehabilitation compliance.Measures should be taken to improve the patient's level of health literacy,so as improve the compliance of rehabilitation and prognosis.